A comparison of sedation-related events for two multiagent oral sedation regimens in pediatric dental patients

Pediatr Dent. 2014 Jul-Aug;36(4):302-8.

Abstract

Purpose: This study compared the incidence of adverse sedation-related events occurring with two different multiagent oral sedation regimens in pediatric dental patients.

Methods: Forty healthy patients (three to six years old), received either a sedation regimen of chloral hydrate, meperidine, and hydroxyzine with nitrous oxide (CH/M/H/N2O; N=19) or a regimen of midazolam, meperidine, and hydroxyzine with nitrous oxide (MZ/M/H/N2O; N=21). The two treating dentists answered a questionnaire regarding the perioperative period. Parents received two phone interviews at eight and 24 hours after sedation. Statistical analysis included chi-square, Pearson correlation coefficient, and t-test (P<.05).

Results: Children sedated with MZ/M/H/N2O showed a significant increase in hyperactivity during dental treatment, slurring/difficulty speaking, and difficulty walking postoperatively within eight hours after discharge. Children sedated with CH/M/H/N2O showed a significant increase in frequency of sleeping, talking less than normal after arriving home, and an increased need for postoperative pain medication.

Conclusions: Different oral sedation regimens produce different adverse sedation-related events. The provider of pediatric oral sedation should select a sedative regimen with an adverse sedation-related profile that he/she believes is optimal for the patient being treated. Parents should be counseled as to possible postsedation effects anticipated based on the sedative regimen administered.

Publication types

  • Comparative Study

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage
  • Adjuvants, Anesthesia / adverse effects
  • Analgesics / therapeutic use
  • Anesthesia, Dental / methods*
  • Anesthetics, Inhalation / administration & dosage
  • Child
  • Child Behavior / drug effects
  • Child, Preschool
  • Chloral Hydrate / administration & dosage
  • Chloral Hydrate / adverse effects
  • Cohort Studies
  • Conscious Sedation / methods*
  • Female
  • Follow-Up Studies
  • Histamine H1 Antagonists / administration & dosage
  • Histamine H1 Antagonists / adverse effects
  • Humans
  • Hydroxyzine / administration & dosage
  • Hydroxyzine / adverse effects
  • Hyperkinesis / chemically induced
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects*
  • Male
  • Meperidine / administration & dosage
  • Meperidine / adverse effects
  • Midazolam / administration & dosage
  • Midazolam / adverse effects
  • Nitrous Oxide / administration & dosage
  • Pain, Postoperative / drug therapy
  • Postoperative Nausea and Vomiting / chemically induced
  • Prospective Studies
  • Sleep / drug effects
  • Speech Disorders / chemically induced
  • Walking

Substances

  • Adjuvants, Anesthesia
  • Analgesics
  • Anesthetics, Inhalation
  • Histamine H1 Antagonists
  • Hypnotics and Sedatives
  • Hydroxyzine
  • Chloral Hydrate
  • Meperidine
  • Nitrous Oxide
  • Midazolam